{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROSEMARIE SCESNY","gend":1,"add":"14309 S EAST SIDE HIGHWAY PO BOX 52","city":"WEYERS CAVE","state":"VA","zip":"24486-9998","dob":"1965-05-31","age":"","mstatus":"","insh":"20034591*01","cliId":"","pno":5408301899,"cno":5408301899,"email":"","ename":"","eno":"","pphy":"SUYES IV, DAVID R PA","ppno":5408866259,"pcpadd":"42 LAMBERT ST STE 511,","pcpcity":"STAUNTON","pcpstate":"VA","pcpzip":"24401-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":5408851696,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.561","M17.0","M54.42","E66.01","M25.562","M54.41","Z68.43","G89.29","M65.9","G57.61","G62.9","M79.671","M79.672","E11.42","M65.872","L03.312","K85.90","E11.9","I10.","E83.42","J20.9","J02.9","Z20.822","W18.30XA","M43.16","M47.816","NO DATA","R29.6","R51.9","M54.2","H47.20","G93.2","H02.59","H25.13","R10.13","G44.89","J18.9","R11.0","M65.871","E11.40","R11.2","R09.81","M25.522","N89.8","E11.69","R10.84","D45.","K52.9","J43.9","E78.5","K04.7","K08.89","I73.00","S89.81XA","S89.82XA","M72.2","M19.079","M51.36","G89.4","M48.061","S20.412A","M54.6","R07.81","M47.26","M51.16","D18.09","M41.9","K21.9","E55.9","Z12.39","Z12.11","Z11.4","Z11.59","Z13.29","D25.9","F17.200","M17.9","M62.81","D18.00","W19.XXXA","E11.65","R50.9","Z98.2","H47.293","E10.40","M51.26","E11.43","B37.9","D75.1","Z68.42","K31.84","E86.1","K59.00","F41.8","Z53.21","M17.12","M16.12","M25.552","L29.3"],"date":["2022-04-27","2022-10-06","2023-05-18","2023-05-18","2023-05-18","2022-01-12","2021-07-15","2023-05-18","2021-08-31","2021-08-31","2023-05-18","2022-04-27","2022-04-27","2021-06-15","2021-06-15","2021-12-21","2022-04-06","2022-10-16","2022-10-16","2022-10-17","2022-05-11","2022-05-11","2022-05-11","2021-02-11","2022-05-25","2022-05-25","2023-05-18","2022-10-06","2022-10-16","2022-05-25","2022-10-07","2022-10-07","2022-10-07","2022-10-07","2022-10-16","2022-10-16","2022-10-16","2022-10-16","2021-08-31","2022-10-06","2022-10-17","2021-09-21","2022-02-16","2022-02-16","2023-05-18","2022-10-17","2022-10-17","2022-10-19","2022-10-17","2022-10-17","2023-07-16","2023-02-19","2021-07-23","2021-06-18","2021-06-18","2023-05-18","2023-05-18","2023-05-18","2021-07-15","2021-07-15","2022-01-12","2022-01-12","2022-01-12","2021-06-08","2022-05-25","2021-06-23","2022-01-12","2023-07-16","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2023-05-18","2021-03-03","2021-06-18","2021-10-30","2021-10-30","2022-04-27","2022-04-29","2021-09-24","2022-03-14","2022-10-16","2022-10-16","2022-10-16","2023-05-18","2022-10-16","2022-10-16","2022-10-16","2022-10-16","2022-04-29","2023-05-18","2023-05-18","2023-05-18","2023-07-16"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","12","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","180","Select","Select",""],["","55111064505","OMEPRAZOLE","40 MG","30","Select","Select",""],["","00591046101","GLIPIZIDE","TAB 10MG","180","Select","Select",""],["","11845005761","B-12","TAB 500MCG","90","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","49483060450","IBUPROFEN","800 MG","90","Select","Select",""],["","00591293201","CLINDAMYCIN","CAP 300MG","42","Select","Select",""],["","16714069211","FLUCONAZOLE","150 MG","1","Select","Select",""],["","80681016600","VITAMIN C","TAB 1000MG","90","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","10","Select","Select",""],["","58657050016","CODEINE\/GG","SOL 10-100\/5","120","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","2","Select","Select",""],["","00093220305","METOCLOPRAM","TAB 10MG","90","Select","Select",""],["","60432046400","LIDOCAINE","SOL 2% VISC","100","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68462018135","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","00023031204","REFRESH LACR","OIN OP","4","Select","Select",""],["","49348068972","SM ANTIFUNGL","CRE 0.02","30","Select","Select",""],["","57896045401","GERI-KOT","TAB 8.6MG","60","Select","Select",""],["","00527512570","LACTULOSE","SOL 10GM\/15","473","Select","Select",""],["","70677005801","SM SENNA LAX","TAB 8.6MG","60","Select","Select",""],["","49348015472","SM ANTIBIOTI","OIN 500\/GM","28","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","14","Select","Select",""],["","10702001850","OXYCODONE HCL","5 MG","8","Select","Select",""],["","69097052444","DICLOFENAC SODIUM","1 %","100","Select","Select",""],["","42858010201","OXYCOD\/APAP TAB","5-325MG","28","Select","Select",""],["","49483060450","IBUPROFEN TAB","800MG","90","Select","Select",""],["","70710113908","FLUCONAZOLE TAB","150MG","2","Select","Select",""],["","67877056310","METFORMIN TAB","1000MG","180","Select","Select",""],["","68180098103","LISINOPRIL TAB","20MG","90","Select","Select",""],["","55111015810","OMEPRAZOLE CAP","20MG","60","Select","Select",""],["","65162019050","NAPROXEN TAB","500MG","60","Select","Select",""],["","00093220301","METOCLOPRAM TAB","10MG","90","Select","Select",""],["","69097052444","DICLOFENAC GEL","1%","100","Select","Select",""],["","68180016006","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","60432046400","LIDOCAINE SOL","2% VISC","100","Select","Select",""],["","68462018135","CLOTRIMAZOLE CRE","1%","30","Select","Select",""],["","00527512570","LACTULOSE SOL","10GM\/15","473","Select","Select",""],["","00023031204","REFRESH LACR OIN OP","","4","Select","Select",""],["","49348068972","SM ANTIFUNGL CRE","2%","30","Select","Select",""],["","70677005801","SM SENNA LAX TAB","8.6MG","60","Select","Select",""],["","49348015472","SM ANTIBIOTI OIN","500\/GM","28","Select","Select",""],["","42858000101","OXYCODONE TAB","5MG","12","Select","Select",""],["","57896045401","GERI-KOT TAB","8.6MG","60","Select","Select",""],["","00093117401","PENICILLIN V POTASSIUM","500 MG","21","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}